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Contraception Flashcards

1
Q

How long does sperm live in the female genital tract?

A

5 days

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2
Q

Describe the appearance of cervical mucus post ovulation

A

Thick and sticky

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3
Q

Describe the positioning of the cervix in the vagina when more and less fertile:

A

More - cervix high, soft and open

Less - low in vagina, firm and closed

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4
Q

In a normal (28 day) cycle, what days is a woman most fertile?

A

Days 8 - 18

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5
Q

What is lactational amenorrhoea?

A

This is a lack of periods in a woman due to her producing breastmilk

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6
Q

What are the three criteria for lactational amenorrhoea to act as a contraceptive method?

A

1) Exclusively breast feeding
2) Less than 6/12 post natal
3) amenorrhoeic

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7
Q

What is the combined hormonal contraception’s basic method of action?

A

Primarily inhibits ovulation

Secondary effects on cervical mucous and endometrium

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8
Q

What is the failure rate of combined hormonal contraception when used perfectly?

A

0.2%

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9
Q

What is the basic mechanism of action for the progesterone only pill?

A

Thickens mucus and inhibits ovulation

Also has effects on fallopian tube transport and endometrium

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10
Q

What is the primary mode of action for the implant?

A

Inhibition of ovulation - long lasting (up to three years)

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11
Q

How long does the depo injection last?

A

14 weeks

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12
Q

How often is the depo injection given?

A

Every 13 weeks

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13
Q

What does the depo injection do?

A

Inhibits ovulation

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14
Q

What is the failure rate of the depo-injection?

A

0.2%

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15
Q

What is the basic mode of action of the copper IUD?

A

Prevention of fertilisation by inhibiting the release of the acrosome of the sperm (acts on sperm Golgi apparatus)
Secondary inflammatory response in endometrium making environment hostile preventing implantation

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16
Q

How long can an IUD remain effective?

A

5-10 years

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17
Q

What is the failure index for the IUD?

A

0.6%

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18
Q

What must be checked for before performing a female sterilisation?

A

Pregnancy

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19
Q

What assessment is carried out before prescribing contraception for a patient?

A

The UKMEC

UK medical eligibility criteria

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20
Q

What examinations are usually carried out before prescribing contraception?

A

Depends on what method
BP and BMI (pulse rate)
Smears up to date and may require you to check uterine size

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21
Q

Define Quick starting contraception:

A

This is when you start contraception when the patient presents and not waiting until next period

22
Q

Give three examples of possible “quick start” contraceptives:

A

CHC’s
Implant
Depo

23
Q

What methods cannot be “quick started”

A

IUDs

Pills containing cyproterone acetate

24
Q

Define ‘bridging contraception’

A

When the preferred method of contraception cannot be started immediately as pregnancy cannot be excluded, therefore an interim is used

25
Give the three options for emergency contraception available in the UK
Intrauterine - copper IUD Oral - LNG-EC (<72hours) - UPA-EC (Up to 120hours)
26
Copper IUD should be offered to ALL women as emergency option. True or False?
``` TRUE Its 10x more effective Has pre and post fertilisation effects Toxic to sperm and ovum Works immediately, regardless of what point in the cycle it is inserted ```
27
If giving the Copper IUD what MUST you rule out?
STI's | Pregnancy
28
Emergency hormonal contraceptive pill is abortive. True/false
False This is a common misconception It only delays ovulation
29
What is the basic mechanism of the UPA-EC pill?
It is an anti-progesterone to delay ovulation
30
What is the basic mechanism of action for the LNG-EC
High dose progesterone to delay ovulation
31
When is hormonal emergency contraception ineffective?
Post-ovulation
32
When should you avoid prescribing UPA_EC?
Severe asthmatics
33
Give some examples of non-contraceptive factors associated with contraceptive methods?
``` Irregular periods Painful periods Heavy menstrual bleeding Endometriosis Menstrual migraine Acne PCOS ```
34
What three factors must be considered before prescribing CHC?
Absorption Metabolism Metabolic effects
35
What are three risks when using CHC?
Venous thrombosis Arterial thrombosis Adverse impact on cancers
36
What metabolic effects can the CHC have?
Reduces levels of anti-thrombin and protein S | Increased fibrinolytic activity
37
What risk factors are associated with VTE according to UKMEC?
``` Obesity Smoking Age Known thrombophilia VTE in a 1st degree relative <45y/o 6 weeks postnatal ```
38
What are unwanted circulatory effects of the combined oral contraceptive?
Systemic hypertension | Arterial disease
39
Why is migraine with aura a contraindication for CHC use?
Migraine with aura has increased risk of ischaemic stroke CHC increases stroke risk Therefore contraindicated
40
What contraception is available for women post-partum from day one?
Progesterone only pill | This is the only option suitable from day 1 post birth
41
What form of barrier method does not protect against HIV?
Cervical cap and diaphragm
42
What is the main method of action in the diaphragm/cervical cap?
Filled with spermicide (therefore inhibiting fertilisation)
43
Give some examples of behavioural methods of contraception:
"pull out" / withdrawal method Periodic abstinence Lactational Amenorrhoea
44
What is the Mirena coil also called?
Levonorgestrel intrauterine system (LNG-IUS) | (a form of progesterone)
45
What is the mechanism of action of the Mirena IUS?
Inhibits implantation through is prostogenic effect on the endometrium Also prevents sperm entering the uterus - preventing fertilisation
46
What else can the Mirena coil be used for other than contraception?
Menorrhagia | Endometrial hyperplasia
47
How long can the Mirena coil be kept in? | LNG-IUS
5 years
48
What % of women will still ovulate while using the Mirena coil as a method of contraception?
75%
49
When can a Mirena (LNG-IUS) be given post partum?
Within the first 48 hours post partum | if not then wait >4 weeks
50
Can the copper IUD be inserted immediately post partum?
Yes within the first 48 hours | After that wait at least 4 weeks

Reproduction (19 decks)

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